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Individual

MARILYN J ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
14201 BRUCE B DOWNS BLVD, SUITE 1, TAMPA, FL 33613-3906
(813) 978-9008
Mailing address
14201 BRUCE B DOWNS BLVD, SUITE 1, TAMPA, FL 33613-3906
(813) 978-9008

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 1355
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59-2202191
FEDERAL TAX I.D.
Enumeration date
11/27/2006
Last updated
05/21/2008
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